The identification of talented individuals isn’t hard. It’s most easily measured directly through observation. In business or athletics, you can start by looking at past performance. But what if you have no past performance to go off of? What if all you have is word of mouth, initial reactions, or perhaps the briefest of interactions during which you need to make an assessment of a person or an organization’s performance? And what if your decision was one that made the difference between life and death?
This past week has been challenging for Cindy and me as our cat Wally was stricken with a host of symptoms, all of which led us to seek medical attention from our regular local area veterinarians. To give you a little background, Wally is a Russian Blue, he’s 16 years old, was a rescue and is cross-eyed which has always made him more than a little crazy. He’s also what I call “clingy and needy with low self esteem”, meaning that he always wants to be on you, purring, drooling or vying for your attention. Of course at any time this cat may suddenly scratch you or bite you while doing the rabbit-kick thing that cats use to eviscerate their prey. Cindy’s mom had her Achilles tendon severed by this lovable animal a few years back. Oh did I tell you that at his prime this cat weighed in at twenty pounds?
Wally lost weight when we moved to New York because I put him on a strict nutritional plan and gave him and his sister/lover/whatever she is female cat “Little Girl” the basement as their room, which means to visit us, he has to do stairs multiple times a day. Suffice it to say that this past summer Wally would have made the cover of the Cat Fancy Under Armor catalog.
Over the past few weeks, however, he started to drop weight significantly and when we finally took him in to get checked, we chose to take him to our local vet in Scarsdale. Now Scarsdale is sort of a hoity-toity village in Westchester County with families with lots of pets and the income to support them in the lifestyles to which they have become accustomed.
Cindy took Wally in and called me up at work with an “It’s bad; Wally is very sick.” message. Wally weighed only seven pounds and was basically a walking skeleton. The doctor took x-rays and said that he had either a mass in front of his heart or his lungs were completely filled with fluids. Either way, they couldn’t tap him until they found out and most likely Wally wouldn’t survive the night. They provided Cindy with the phone number of a crematorium that would pick Wally up at our house when the time came.
He went on lasix for the fluid and an antibiotic. Saturday rolled around, then Sunday rolled around and while he was lethargic, he was still jumping onto the bed, still doing his stairs, still eating Little Girl’s food and still swiping at us on occasion for no apparent reason. We thought if nothing else, the quality of his life had improved. Things were looking up. On Monday we called the vet and he scheduled an echocardiogram for Tuesday at the same animal hospital.
Wally’s condition deteriorated dramatically. He would lay around listlessly and his breathing was very labored. He became cyanotic and his gums turned blue indicating that he wasn’t taking in enough oxygen. Cindy and I at 9:30pm had to decide what to do. Relying on the vet’s advice, we figured that the mass was pressing against his heart and this was creating complications and not allowing him to breath properly. This might well be his last night. If we take him to emergency, what would they do with him? They couldn’t do surgery, according to the regular vet. So what would we be trying to do? Was it better to continue to fight or at least allow Wally’s last night to be with the warmth and familiarity of his family? Or was it better to at least take him in in the hope that they might at least make him more comfortable? We figured that they might be able to put him on oxygen to help him breath and then perhaps he would be strong enough to do the echo as scheduled. So off we went to the Emergency Room with our cat. We were quickly brought in to see the ER vet, a Dr. Chun. Now this is where I get back to judging competency or talent. Dr. Chun examined Wally and repeated the diagnosis of our vet. She didn’t have the x-rays, but said that his diagnosis made sense so that should essentially be that. She put Wally in a oxygen tent, which is more like an aquarium. We watched Wally in this fiberglass enclosure struggling to breathe, knowing that the oxygen would give him the best opportunity to do so, but also fearful that Wally’s last minutes or hours would be spent in this cold and unfeeling environment. Dr. Chun told us that they had other animals to work on so we had to leave.
Cindy and I remained in the waiting room and one of the nurses came out to tell us that there would be no more visiting opportunities tonight. Given that we weren’t sure that this would be Wally’s last night, I wasn’t too thrilled with that assessment, and so I told Cindy that we would stay in the waiting area, and presumably at some point, no more sick animals would be coming in and we could go back in to see Wally. Dr. Chun was really annoyed by our stubbornness. Basically, I figured that the years in her job must have desensitized her to the bonds that are created between family members two and four legged varieties alike. So we waited and we waited and we saw animal after animal get brought in and get treated. Finally one of the nurses, I think inspired by our dedication, came out and said we could poke our heads in for a minute. Wally was laying on his side, not moving, and staring at me. I placed my head near to his separated by the glass and a tear dripped from his eye. I know that he tears regularly but it seemed this was essentially the only emotion he could muster in his condition. I stared at his chest and saw that the tachycardia had diminished somewhat and his breathing was more regular but still strained. I was certain, if we took him home with us, he would have passed away under great discomfort or pain. Dr. Chun explained: “There’s nothing else we can do until you get the ultrasound done on him tomorrow.”
Now here begins the interesting case study on veterinary service in Westchester County. In Westchester County, most of the animal hospitals, I have discovered through this process, do not have their own ultrasound machines, so there are two, count them two doctors who are board certified to do the ultrasounds, one in Westchester and one on Long Island. They drive around from animal hospital to animal hospital on their own schedule performing this specialty service. Given that my cat appeared to be on death’s door I asked if we could call this guy. “Oh no, he’d never come out this late.” So I scratched my head and said, “Okay, well how can we guarantee that he’ll be at our regular veterinarian in the morning?” “Well you can’t.” “Can you call him and ask?” “No it doesn’t work like that.” “Why not?” “Well, because he travels around and the timing depends upon how many he has to do at the various other hospital he goes to before he gets to yours. Yours might be the first or it might be the last.” “So if no one knows, let’s call him an entice him to come to my hospital first.” “Sorry, it doesn’t work like that.” “Great. So I’m supposed to hope that my cat makes it through the night in an oxygen aquarium and then hope that this traveling doctor will get to my hospital in time to do his thing so we can finally begin to treat the poor animal who hasn’t by the way had food or water since midnight in the off chance that my hospital might be first on his milk route?” “Sorry.” “You could drive down to Manhattan to Animal Medical Center; they have everything over there, including cardiologists on staff. But they might not have the cardiologist there tonight even if they have someone to do the ultrasound.” “Well can we call over there?” “Sorry, they turn their switchboard off at night, and if they aren’t there you’ll have to transport an already weakened cat back up here and he might not make it.”
I’m getting pretty frustrated by now and don’t want to cause anymore stress to Wally tonight, so I decide to play the odds, leave him in his oxygen aquarium for the night and transport him on oxygen to our regular vet in the morning to meet with the traveling ultrasound guy. I place my USC sweatshirt into his aquarium so at least he has something familiar around him to lay on. Oh by the way, the bill for the oxygen aquarium for the night? $640. “We’ll be back at 7:30am to take him over to our vet”, Cindy says to the nurse. “No don’t come until eight o’clock because you don’t want to take Wally off of oxygen until you know that your vet is open and they don’t open until 8:00 am.” We were kicked out of the waiting room at 1:30am.
A few hours later, we were back in the car arriving back at the emergency center at 8:00 am, sharp. Dr. Chun walks out and before telling us about the status of our cat, whether he was alive or dead, she blurts out “You’re late!” Cindy who cried most of the night had now had enough and ripped into her. Not only were we told not to come at 7:30 am by the nurse, this doctor’s bed-side manner plained sucked! At what point does the magic of helping to save lives turn into just a job, something one does to pay the bills, so you can buy groceries or a new Porsche? This concept fascinated me in some twisted way. This vet knew how upset we were and her first action was to lash out at us – unbelievable.
So here we are driving on the Bronx River Parkway with a four foot tall oxygen tank on rollers and a cat inside a container sealed except for a small hole for the oxygen tube. We arrive at the Scarsdale Animal Hospital at 8:30am. We take Wally inside and tell them that this is a carrier with a limited supply of oxygen, he is scheduled for an ultrasound, please take Wally and put him onto their oxygen system and may we speak with the doctor? They don’t want to take Wally out of that container, the vet doesn’t show up until between 9:30 am and 10:00 am and I can’t really tell you when the ultrasound guy will be here, and oh by the way, he’s not a doctor. The ultrasound guy is a technician, and the charts will still need to be looked at by a doctor. Those results won’t be back until tomorrow. I am furious at this point. Has anyone noticed that we have a cat in critical condition, and supposedly your job is to provide care to cats so that his health might improve using technological advances that have occurred sometime after George Washington made his wooden teeth?
I finally blurt out, “I don’t care about any of your administrative issues or policies that you have set up, I want my cat to receive the best treatment available, how do I do this?” “As soon as the doctor gets here, he can give you that information.” Sheepishly, I sit down and count the minutes. Just as a Plan-B, I call the Animal Medical Center in Manhattan and am surprised when a human being answers the phone, and then further surprised when she shows some level of compassion , urgency and professionalism. I make an appointment with a cardiologist at 11:30 am, and yes they can do the echo and yes he can look at the results immediately and treat the cat’s situation.
The vet finally decides to show up at work and he says: “Well he looks much like he did on Friday.” “If you do the ultrasound here, we won’t get the results until tomorrow and he might not make it through the night.” “OK, so where else can we go that has not only an ultrasound but a qualified vet to read it and provide treatment?” The vet then tells me that there is a great cardiologist in Katonah, about 40 minutes north of Scarsdale but potentially quicker than going to Manhattan, since we’ll have to transport Wally on whatever oxygen is left in the tank, because these people wouldn’t put Wally into their oxygen system. So the receptionist calls the Katonah Animal Hospital and they page the cardiologist because apparently he also doesn’t keep regular office hours. I look at my watch and it is now 9:45 am. I know it will take at least an hour to drive to Manhattan so I agree to wait 30 minutes for this cardiologist to call our vet back. Tick tock, tick, tock. Finally, the cardiologist calls back and our vet says he can’t see you until 3:00 pm today.
I immediately tell the vet to prepare Wally for transport, and holler out to Cindy, “Let’s go, we’re going to Manhattan.” We wheel the $250 oxygen canister (reading low) and Wally’s makeshift oxygen container back out to the car and begin driving into Manhattan.
We arrive at 62nd and York at 11:15 am. The oxygen ran out completely during the drive and now Wally is out of the container because the container was sealed. No oxygen means no breathing and I didn’t want the cat to die of suffocation on the FDR heading down through Manhattan. I pull our car up onto the sidewalk across the street and Cindy jumps out and takes Wally into the building while I find a place to park.
I make my way on foot over to the Animal Medical Center and as soon as I walk up to the door, immediately, I sense something is different. There are etchings of dogs, rabbits and cats on the glass doors. There are ramps for animals to make their way up to the 2nd floor reception area and not known to me, there was emergency drop off and parking just for the hospital as well. At the reception area, I find Cindy and she tells me that upon arriving, they called out a code and no less than four doctors ran out and whisked Wally away into the hallways of this hospital. One immediately came back out and explained exactly what they were doing and when they would get back. He came back out as promised and explained that they were optimistic, that he seemed to be stable and they would tend to him immediately. The waiting room was filled with people and their animals. While we were waiting, doctors came out one after the other to speak with the people in the waiting area, some with smiles, all with positive attitudes and compassion, and all as professional and as caring as could be. It was then that I realized what was going on. This was a teaching hospital for animals. Well, not for teaching animals but for veterinarians. These interns and residents scurrying around still believed that they were making a difference, that they were in the business of saving lives, not trying to put their kids through Scarsdale schools. Their purpose was to enhance the quality of life at every opportunity while never forgetting that their four-legged or talon-laden patients were no less important than the patients a few blocks down at Weil Cornell Medical Center at NY Presbyterian Hospital.
We waited for a long time, but never felt like Wally was just sitting in some cold dark room waiting to be tended to or to die. These people in their actions, attitude, demeanor and professionalism instilled a confidence that we had been sorely lacking. When Dr. Fox came out to talk to us, he reviewed everything that had been done and discussed what they were going to do. Already he had removed about 50% of the fluid from Wally’s lungs (our vet said they couldn’t do that), he had tranquilized him to calm him down and they had him on oxygen with an IV to help balance out the electrolytes, which was tricky because of the collecting fluids, but absolutely necessary given his current condition. He assured us that in ICU, there was a doctor watching over him and his stats. Dr. Fox said, he would do the echocardiogram on him and be back out to tell us what he found.
It was about an hour before Dr. Fox came back out. During that time we socialized with the other people waiting, all of which had family members inside for one reason or another. Over the loud speaker, we would hear “Dermatology line 403, or Orthopedics, line 502.” This place was amazing. They treated large animals, small animals; they had cardiologists and orthopedists and oncologists and ophthalmologists and every kind of specialist you could imagine. The little Yorkie next to us was having a consultation to have his anterior cruciate ligament surgically repaired. Toxicologists were discussing options and treatments with a man who’s Chow had swallowed rat poison. To everyone in this building, which was multiple stories high, these were patients and their job was to improve the health of their patients. When a dog came in who’s tongue was blue, all of the doctors in the waiting room with patients, jumped up and ran to help this critically ill patient. These people love what they do. This is not something that one can fake – not that well. So what was it about this place and its culture that promoted that attitude consistently throughout all of their employees? Why were the animal hospitals in Westchester so substandard in both their treatment and their demeanor in comparison? I thought about that while we waited.
When Dr. Fox did return, he explained that he believed that Wally has a hyperactive thyroid which accounts for the ravenous appetite and yet the dramatic loss of weight. He doesn’t believe that the mass that is developing is cancerous but the hyperactive thyroid is most probably also responsible for the fluid in the lungs, the tachycardia and the anemia. He told us that Wally had been through a lot and a lot of damage had been done. He described our options and the possible course of treatment. He balanced the fact that Wally was 16 years old with the confidence that regardless of Wally’s age, he wasn’t yet done with his full and happy life. This isn’t to say that Wally wasn’t still in critical condition. But he felt that if we could get Wally past this hump with medications to reduce the thyroid, we could then discuss next steps. This was the same animal that our vet was ready to euthanize on Friday and again this morning.
Dr. Fox, through his actions, through his respect for Wally, through his genuine understanding for how much Wally means to us, through his patience and through his clear and concise explanation of the issues and the possible courses of action gained our confidence that Wally would be receiving the best treatment available. We agreed upon a course of action that made Wally a temporary resident of the ICU at Animal Medical Center. We were told that we could visit him between the hours of 3 pm and 7 pm and they would probably keep him for the next three to four days as they balanced the thyroid medication with the medication and treatments to continue to reduce the fluids in his lungs. When we went to visit Wally, he was among other animals in large glass oxygen containers and he had an IV in his arm and a heart rate clip on his paw to monitor his vitals. As I placed my head near to the glass, he took a swipe at me, which I took for a good sign. He has a long way to go, and anything can happen, good or bad, but at least I feel that he is with people that genuinely care about the outcome and impact of their work, and care about all of their patients, two and four legged alike. Animal Medical Center is an establishment that I would recommend to anyone that will listen. What they have created there is amazing and unique. But it doesn’t have to be.